Hamstring Tendonitis - The Complete Injury Guide

Hamstring tendonitis, also known as a hamstring tendon tear or hamstring tendinopathy, is a common condition experienced by athletes, regular gym-goers, and older adults.

Tendonitis can be experienced in different areas of the hamstring, and it is classed by the ICD-10 (the World Health Organization’s medical classification list) based on the area it affects. As a result, you may hear you have lower hamstring tendonitis, distal hamstring tendonitis, lateral hamstring tendonitis, or proximal hamstring tendonitis.

Regardless of what it’s called or where it is located, one thing is for certain—hamstring tendonitis hurts!

Read on to discover more about hamstring tendonitis, plus its causes, symptoms, and the many treatments available for this painful and debilitating condition.

What is Hamstring Tendonitis?

Hamstring tendonitis is essentially inflammation in one or more of the hamstring tendons.

These tendons are the soft tissues that connect the hamstring muscle to the outer part of the knee, and they assist the hamstring muscles in bending, straightening, running, jumping, and kicking.

Both the hamstring muscles and tendons are vital to our everyday activities. We should always protect them strain or injury.

Hamstring Tendonitis Causes and Risk Factors

You may have hamstring tendonitis for many reasons, ranging from lack of stretching to dancing. Common causes of the hamstring tendonitis include:

Overworked Tendon

The number one cause of hamstring tendonitis is working the muscles and tendons too hard, such as carrying heavy loads or repetitive motions.

Overworked tendons and muscles are a common complaint among athletes and people who work out excessively. What’s more, fatigued muscles reduce energy-absorbing abilities, which naturally affects the nearby tendons.

Tight Muscles

If you don’t stretch your muscles regularly, especially before and after exercising, you likely have tight muscles. This causes increased stress on the hamstring tendons, leading to tendon strain and injury.

Weak or Imbalanced Muscles

We’re not composed of isolated muscles and tendons—all our body parts work together to help us function. If there is an imbalance in one group of muscles, the others have to pick up the slack, putting themselves and their nearby tendons at risk for strain. Strengthening all your muscle groups helps the body cope with physical activity and reduces the risk of injury.

Type of Activity

The risk of hamstring tendonitis is highest among:

Older adults whose main physical activity is walking

People who play football, soccer, or basketball

Runners

Dancers

Diagnosing Hamstring Tendonitis

Diagnosis of hamstring tendonitis can be carried out at home, by evaluating your symptoms and using simple flexibility tests, or by seeing a doctor for a physical exam and X-ray.

Symptoms of Hamstring Tendonitis

It’s possible to diagnose hamstring tendonitis based on symptoms alone. In fact, your doctor will require a detailed description of your symptoms. Here are the main signs and symptoms of hamstring tendonitis.

Upper hamstring pain when sitting

A sudden, sharp pain in the back of the thigh during physical activity

Pain that gets gradually worse during physical activity

Swelling or bruising on the back of the leg

Persistent weakness in the hamstring

A dull ache or stiffness when waking

In severe cases, pain and swelling in the thigh and calf

DIY Tests for Hamstring Tendonitis

A 2012 paper outlined three tests to check for the presence of hamstring tendonitis. In the study, the tests showed between 76 and 89% accuracy in diagnosis.

While you can carry out these tests at home, you should follow up with a doctor for a formal diagnosis.

Pain during any of the following tests suggests you have hamstring tendonitis.

Test 1: Standing Hamstring Stretch

Simply prop your heel on the seat of a chair. Flex your foot until you feel a stretch in your hamstring. You may need to bend forward slightly at the hips to increase the stretch. Click here to jump to a video demonstration.

Test 2: Assisted Hamstring Stretch

Lie on your back on a mat. Flex your hip and knee, and have another person gently and slowly straighten your knee to stretch out your hamstring.

Test 3: Fast Assisted Hamstring Stretch

In the same position as the second test, flex your hip and knee. Straighten your knee quickly, rather than slowly.

Professional Diagnosis of Hamstring Tendonitis

Your doctor will diagnose your hamstring tendonitis primarily based on a physical exam, but imaging techniques may also be used. As part of the physical exam, the doctor will take a full medical history and inquire about your symptoms. They may also apply pressure to the back of your thigh to check for pain, weakness, or inflammation.

If the doctor does not have enough information from the physical exam, or if your symptoms are severe, they may order imaging techniques, such as an X-ray or an MRI scan. These scans also help rule out complications. An X-ray can highlight a hamstring tendon avulsion—when the tendon separates from the bone. MRI scans are used to indicate other kinds of damage to the hamstring muscles and tendons.

Hamstring Tendonitis Treatment

There are many treatments available for hamstring tendonitis, ranging from simple self-administered interventions to surgery for more serious cases. Here are nine options to consider for treating hamstring tendonitis.

1. RICE - Rest, Ice, Compression, Elevation

In the first 72 hours following a hamstring injury, the RICE method is important to speed the healing process.

Rest. Resting your leg is vital for giving the injury time to heal. Putting constant weight on the leg, or engaging in strenuous activities, can cause further damage and will exacerbate inflammation.

Ice. Using ice packs or even bags of frozen vegetables helps reduce pain and inflammation. Ice packs can be applied for 15 minutes every four hours or as needed.

Elevation. Keeping your hamstring raised by lying down and propping your leg on cushions, a stirrup, or the end of the bed will help restrict blood flow and reduce inflammation. To see benefits, you need to raise the hamstring above the level of the heart.

2. Hamstring Tendonitis Brace

Utilizing a hamstring brace provides added support while performing your everyday activities. It also helps to protect re-injury. ( See Product).

Keeping your leg immobilized with a hamstring brace or compression support allows the muscles and tendons to relax and recover. A brace also keeps the leg in a neutral position, which aids healing.

Braces can be worn post-recovery during exercise to prevent re-injury.

Hamstring braces can be purchased over the counter or online and ensure your hamstring gets the rest it needs. Choose a brace made from a breathable fabric and that can be adjusted to suit your needs.

3. Taping and Strapping

These techniques are often used for hamstring injuries. They support the leg, stabilize the hamstring, and reduce stress on the muscles and tendons.

You may wish to continue taping and strapping during physical activity even after the hamstring has healed. These methods can prevent further damage and keep you from developing a new case of hamstring tendonitis.

4. Hamstring Tendonitis Exercises

Once the pain and inflammation in your hamstring have subsided, you may begin a physical therapy program that includes stretching exercises and strengthening exercises to improve mobility, flexibility, and strength.

Consult with your doctor or physical therapist at all stages of rehabilitation, and let them know if you experience any pain, swelling, or other adverse effects. Always stop your rehabilitation exercises if symptoms get worse.

Stretching Exercises for Hamstring Tendonitis

In the initial stages of physical therapy, gentle stretches help improve your range of motion. Try these stretching exercises for hamstring tendonitis.

Straight Leg Raise

Lie on your back on a mat. Keep the injured leg straight, and bend your other leg at the knee.

Slowly lift the straight leg until you experience a mild stretch. Hold for 2 seconds and lower to the floor.

Repeat for 10 repetitions. You can do up to 3 sets of this exercise daily.

Repeat this for 10 repetitions. You can do up to 3 sets of this exercise daily.

5. Hamstring Massage

A deep-tissue massage can help loosen tight muscles, stimulate the healing of scar tissue, and improve blood circulation—all of which help support your hamstring tendons and aid healing. A sports or physical therapist can perform this type of massage as part of your rehabilitation program.

Foam rollers are a great way to give your hamstrings an at-home massage and to stimulate healing.

Note that massage should not be carried out in the first few days after injury, as it can increase bleeding and inflammation.

6. Contrast Therapy

This easy at-home treatment is a low-risk way to manage symptoms of hamstring tendonitis. Simply alternate one minute of cold application with 3 minutes of heat for 10 to 15 minutes, beginning and ending with a cold pack. This treatment can be repeated once or twice daily as necessary.

Be careful not to burn yourself with heat or ice, and do not attempt this therapy in the first 72 hours after injury. Within this timeframe, only ice therapy should be used.

7. Medication

If you are in severe pain or are experiencing a lot of swelling, your doctor may recommend anti-inflammatory medications or corticosteroid injections. Over-the-counter anti-inflammatories, such as aspirin or ibuprofen, can be taken according to the instructions on the packet.

Severe cases of hamstring tendonitis may require an injection, particularly if other treatments aren’t providing adequate pain relief. These corticosteroid shots come with their own risks—your doctor should inform you of all the pros and cons before administering.

8. Electrotherapy

Electrotherapy for hamstring tendonitis involves the application of a probe to the affected area. Shock waves are delivered to the damaged tendon in order to boost circulation and break up scar tissue.

Electrotherapy can be easily administered at home using a personal TENS unit. Remember, to consult with your doctor to ensure that using electrotherapy for relief is best for your injury. Benefits range from increased movement & strength, and even a shorter recovery time.

9. Medical Treatments and Surgery

Several medical procedures are available for hamstring tendonitis, ranging from minimally invasive to surgical treatments. Your doctor will advise you on the best choice for your individual needs.

Options include:

Ultrasound-guided needle tenotomy

Platelet-rich plasma injections

Tenex procedure

Debridement surgery

Tendon release surgery

Hamstring Tendonitis Recovery Time

After a hamstring injury, a common question is, “Does hamstring tendonitis go away?”

While hamstring tendonitis may seem to last forever, it can and does heal for the vast majority of people.

Hamstring tendonitis recovery time varies depending on the severity of your injury and on your overall fitness level. One thing is for sure—early intervention is key to a speedy recovery. People who use the RICE protocol and physical therapy tend to enjoy better and quicker results. Even so, some people using non-invasive treatments can expect the recovery period to last three to six months.

Those who elect to have surgery and other medical procedures may recover more quickly. However, some types of surgery actually require longer recovery periods.

Research suggests that the risk of re-injury is a major problem in cases of hamstring tendonitis. Once you’re fully healed, take all the necessary steps to prevent recurrence. Otherwise, you risk permanent damage and a chronic hamstring condition.

How to Prevent Hamstring Tendonitis

Whether you have already experienced hamstring tendonitis, or you never want to, be sure to follow these steps to keep your hamstrings fully functional.

Stretch It Out

Regular stretching prevents injury and keeps your muscles flexible and mobile. Stretch out your hamstring every day, especially before and after workouts.

Here are four of the best hamstring stretches, with easy-to-follow instructional videos.

1. Seated Hamstring Stretch

2. Chair-Assisted Leg Lift

3. Standing Hamstring Stretch

4, Double Leg Glute Bridge

Achieve Muscle Balance

By strengthening all the muscle groups in our body, we provide the necessary support and balance to our hamstring tendons. Work with a fitness professional or a physical therapist to create the perfect workout plan for you. To reduce the risk of injury, consider using hamstring supports—such as braces, taping, or strapping—during your workouts.

Hydrate

Dehydration can cause muscle cramping, increasing your risk of tendon and muscle injury. Stay hydrated by drinking lots of water before workouts and in hot weather.

Enjoy drinks like coffee, tea, and alcohol in moderation. These are diuretics, which can contribute to dehydration.

Recover After Workouts

Prevent Hamstring Tendonitis

Our hamstrings play a vital role in our physical functioning. Taking care of our hamstring tendons and muscles is imperative to our overall health and wellbeing. If you're experiencing hamstring pain, consult with your doctor to find the best recovery regimen for you.

By respecting our muscles and tendons and the work they do, and by providing them with adequate rest and support, we can avoid hamstring tendonitis and enjoy a full range of mobility and flexibility, now and for years to come!

Jessica Hegg

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